Premenstrual Dysphoric Disorder (PMDD)

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Is PMS different from PMS?

PMS vs. PMDD - What's the Difference?

Ms. B.T. is 38 years old. Her co-workers always seem to know when she has her period. During this time, she becomes extremely irritable. She feels guilty because she gets very angry at her children for no logical reason or for apparently trivial reasons. In fact, one of her coworkers, with whom she is quite friendly, suggested she come in before her supervisor noticed problems on the job. She heard that there is a severe version of PMS that requires special treatment.

Premenstrual dysphoric disorder (PMDD) facts

  • Premenstrual dysphoric disorder (PMDD) can be considered to be a severe form of premenstrual syndrome (PMS), with symptoms that interfere with daily activities and functioning.
  • PMDD occurs in 3% to 8% of menstruating women.
  • Fatigue, mood changes, and abdominal bloating are common symptoms, but numerous other symptoms may occur.
  • PMDD is diagnosed by a symptom diary or chart in which a woman records her daily symptoms for at least two consecutive menstrual cycles.
  • PMDD is effectively treated by medications including SSRIs and drugs that suppress ovulation and the production of ovarian hormones.

What is premenstrual dysphoric disorder (PMDD)?

Premenstrual dysphoric disorder (PMDD) can be considered a severe form of premenstrual syndrome (PMS). Both PMS and PMDD are characterized by unpleasant physical and psychological symptoms that occur in the second half of a woman's menstrual cycle, most commonly in the days preceding the menstrual period. Physical symptoms such as bloating, breast tenderness, headachesjoint pain, food cravings, mood swings or frequent crying, panic attacks, fatigue, mood changes, irritability, and trouble focusing are among the most common symptoms. Other symptoms like anxiety and trouble sleeping have been reported. PMS symptoms may be troubling and unpleasant. PMDD may cause severe, debilitating symptoms that interfere with a woman's ability to function.

The American College of Obstetricians and Gynecologists estimates that at least 85 percent of menstruating women have at least one PMS symptom as part of their monthly cycle. PMS is much more common than PMDD. You must have 5 or more of the symptoms listed above to be diagnosed with PMDD.

Biologic, psychological, environmental, and social factors all seem to play a part in PMDD. It is important to note that PMDD is not the fault of the woman suffering from it or the result of a "weak" or unstable personality. It is also not something that is "all in the woman's head." Rather, PMDD is a medical illness that impacts only 3% to 8% of women. Fortunately, it can be treated by a health care professional with behavioral and pharmaceutical options.

PMDD has been previously medically referred to as late luteal phase dysphoric disorder.

Medically Reviewed by a Doctor on 2/6/2015
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